Expert calls for council to unify Thai healthcare systems

[webfact]

Expert calls for council to unify health systems
CHULARAT SAENGPASSA
THE NATION


Ammar

'CENTRAL FORUM NEEDED TO KEEP THREE BODIES IN STEP TO DRIVE THE HEALTHCARE SECTOR'

BANGKOK: -- A LEADING health economist is pushing for the establishment of the National Health Security Council (NHSC) to facilitate co-operation between, not to merge, the country's three major healthcare systems.

"We need such a council to create an effective forum for talks so that those involved can drive the country's healthcare sector forward," said Prof Ammar Siamwalla, an academic at the Thailand Research Development Institute and also chairman of the prime minister-appointed coordination committee for health security.

In an exclusive interview with The Nation, he said the NHSC should be chaired by the prime minister and staffed by the public health minister, labour minister, finance minister and representatives from various agencies.

"With the NHSC, those in charge of managing the three schemes won't just form a loose collaboration. They will make decisions together to ensure the sustainability of the country's healthcare sector," the economist said.

The country's three main healthcare systems are: the universal coverage healthcare scheme, which covers about 48 million people; the social security scheme, which covers about 10 million people; and the health-benefit scheme for civil servants and their family members.

These three schemes offer different coverage of medical benefits, with the scheme for civil servants and their family members offering the best coverage. The scheme for civil servants also costs more per-head than the other two.

"But I can assure you that the NHSO will neither push for the merger nor try to control these schemes," he said.

In recent years, several critics have lamented the different standards among the three schemes. Yet, many others have strongly opposed the idea of merging the schemes. Many civil servants, for example, are worried that their medical benefits will shrink if such a merger takes place. Some civil servants, after all, have stayed in the public sector because their health welfare and medical benefits are better than those offered in the private sector, even if their salaries are lower.

Many observers believe the social-security scheme has the fewest benefits. Even though the scheme's members have to pay monthly contributions to get themselves covered, they seem to enjoy fewer benefits than those exercising their right to free medical treatment under the universal coverage healthcare scheme.

While Ammar claims the NHSC shall not merge the three existing schemes, he has made it clear that it would strive to reduce the gaps in benefits.

"It's necessary that we reduce the gaps. I've heard that some people don't want to work because they will lose their right to free medical services as soon as they become officially employed," Ammar said.

Thai law requires the gainfully employed to join the social security scheme and pay monthly contributions. The universal coverage healthcare scheme, meanwhile, covers all those who are not covered by either the social security scheme or the medical benefits associated with civil servants.

Middle-class members who are not happy with either the social security scheme or the universal coverage healthcare scheme usually opt for expensive doctors at private hospitals and pay their own fees.

While this practice reduces overcrowding at medical facilities and eases the budget constraints of the schemes, Ammar said it would backfire on the country's healthcare sector in the long run.

"When private hospitals attract a lot |of paying patients, they can offer higher pay to medical workers. Then, doctors |and nurses at state hospitals will demand higher pay when they see how much their peers in the private sector can earn. |That means the government will have to shoulder higher costs in the end," Ammar said.

He said both the universal healthcare scheme and the social security scheme will have to bring their disgruntled members back to their services.

The NHSC is part of the National Security Bill that several experts, including Ammar, have been trying to push ahead. He said everyone should understand that existing mechanisms cannot really bring agencies in charge of managing the three major healthcare schemes on the same board for crucial decisions.

"That's why we need the NHSC," he said.

While the NHSC would not provide instant solution to all of the country's healthcare problems, he said, it would pave the way for fruitful discussions that could lead to real action.

Ammar believes that medical schools' hospitals and major hospitals should focus on providing tertiary care or treat complicated diseases for patients transferred from primary or secondary medical facilities.

"We also should try to engage more private hospitals in the delivery of healthcare services via the universal coverage healthcare scheme," he said.

Ammar gave an exclusive interview to The Nation ahead of the First National Conference on Thai Universal Healthcare Coverage (2015): Universal Health Coverage: achievements, challenges and harmonisation, which will take place on November 16 and 17.

Source: http://www.nationmultimedia.com/national/Expert-calls-for-council-to-unify-health-systems-30272544.html


-- The Nation 2015-11-09

[fred Kubasa]

Many sons/daughters/nieces/friends of "connected people" are unemployed so

best to form 23 new committees with 198 new employees !

Edited November 9, 2015 by fred Kubasa